Watching alcoholism destroy a person’s life can be painful. Those around may wonder why an alcoholic is unable to just walk away from a drink. However, scientists are beginning to understand that there are two distinct types of alcoholics. This distinction is important in developing treatment strategies that help treat alcoholics.
The first group are alcohol abusers. Alcohol abusers can drink heavily for periods of time, yet are able to walk away from their drinking abuse with little or some persuasion. Alcohol abusers usually benefit from the 12 step program that Alcoholics Anonymous (AA) offers. These alcoholics are cognizant enough to consider the positives and negatives associated with their drinking and eventually decide that the perceived benefits are unfounded which leads them to quit drinking on their own or with some intervention.
The second group are alcohol dependent. Alcohol dependency can be defined as a brain disease. An alcoholic in this group will drink alcohol until they die unless intervention occurs. In this case the brain is dependent on the alcohol consumed to function. The transition from alcohol abuser to alcohol dependent can be genetically predetermined. It however takes other factors, such as environmental factors which can be psychosocial, to make the transition. There are different reasons why individuals remain abusers and why some transition on to become dependents but the genetic reason is increasingly being studied. Researchers are finding that alcohol dependent individuals have structural differences in their brain’s dopamine reward system. This creates a target for possible treatment strategies.
After the initial drink of alcohol, individuals experience a burst of dopamine. The dopamine elicits a pleasurable response. This response is desirable and people will continue to drink alcohol to attain the rewarding effect. As a social drinking steps beyond drinking socially and (begets binge drinking) to drink only to obtain the reward; they become an alcohol abuser. At some point the neurotransmitters associated with the pleasure reward system change their pathways and no longer impart a noticeable reward. This drives an alcoholic to drink more to get the pleasurable reward. At this point an alcohol abuser can weigh their options and quit whilst a dependent can’t.
Alcohol dependent individuals have a harder time overcoming their alcoholism because their problem is an actual brain disease. Researchers are working on finding the specific neuro-chemicals that responsible for responsible for alcohol dependency. Once this is determined a drug could theoretically be developed that would break the craving cycle. In the mean time there are drugs that can be used to either minimize or cancel the neurological effect of alcohol or drugs that deter alcoholics by creating negative physical symptoms once alcohol is consumed.
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